{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:59:30Z","timestamp":1765727970585,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Mitral valve prolapse (MVP) is commonly benign, but may result in life-threatening arrhythmias and sudden cardiac death (SCD). Mitral annular disjunction (MAD) often coexists with mitral valve prolapse (MVP) and has been implicated in the development of ventricular arrhythmias through myocardial stretch and fibrosis. Case Presentation: Here, we present a case that highlights the diagnostic value of multimodal imaging in evaluating ventricular ectopy in the context of MVP and MAD. A 72-year-old male presented to the cardiology clinic with palpitations and fatigue, compounded by an arrhythmia identified by his Apple Watch. Holter monitoring revealed premature ventricular contractions (PVCs), with cardiac magnetic resonance imaging (CMR) demonstrating MAD and basal inferolateral scarring. Despite minimal symptoms and normal echocardiographic imaging, CMR findings highlight the utility of advanced cardiovascular imaging in patients with newly detected ventricular arrhythmias. Conclusion: This case highlights the importance of integrating consumer wearables and advanced imaging in evaluating ventricular ectopy and its evolving role in risk stratification for patients with MVP, even in the absence of overt symptoms.<\/jats:p>","DOI":"10.3390\/reports8020094","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T04:20:23Z","timestamp":1750134023000},"page":"94","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unraveling Mitral Annular Disjunction: A Case Report of Ventricular Arrhythmia Detected via Smartwatch"],"prefix":"10.3390","volume":"8","author":[{"given":"Samantha","family":"Lo","sequence":"first","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai Elmhurst Hospital Center, Queens, NY 11373, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3227-3295","authenticated-orcid":false,"given":"Sanjay","family":"Sivalokanathan","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai Morningside\/West, New York, NY 10025, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Kukar","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai Morningside\/West, New York, NY 10025, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1161\/hc4601.099489","article-title":"Activated interstitial myofibroblasts express catabolic enzymes and mediate matrix remodeling in myxomatous heart valves","volume":"104","author":"Rabkin","year":"2001","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJM198511213132101","article-title":"Echocardiographically documented mitral-valve prolapse: Long-term follow-up of 237 patients","volume":"313","author":"Nishimura","year":"1985","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e010584","DOI":"10.1161\/JAHA.118.010584","article-title":"Mitral valve prolapse and sudden cardiac death: A systematic review","volume":"7","author":"Han","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1161\/CIRCULATIONAHA.115.016291","article-title":"Arrhythmic mitral valve prolapse and sudden cardiac death","volume":"132","author":"Basso","year":"2015","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/j.jacc.2018.07.070","article-title":"The mitral annulus disjunction arrhythmic syndrome","volume":"72","author":"Dejgaard","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1136\/heartjnl-2017-312932","article-title":"Mitral valve prolapse and sudden cardiac death: A systematic review and meta-analysis","volume":"105","author":"Nalliah","year":"2019","journal-title":"Heart"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_8","first-page":"376","article-title":"Prevalence and extent of mitral annular disjunction in structurally normal hearts: Comprehensive 3D analysis using cardiac computed tomography","volume":"13","author":"Toh","year":"2020","journal-title":"J. Am. Coll. Cardiol. Imaging"},{"key":"ref_9","first-page":"196","article-title":"The analysis of mitral annular disjunction detected by echocardiography and comparison with previously reported pathological data","volume":"69","author":"Konda","year":"2017","journal-title":"J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jacc.2020.06.029","article-title":"Presentation and outcome of arrhythmic mitral valve prolapse","volume":"76","author":"Essayagh","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","first-page":"e005030","article-title":"Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse","volume":"9","author":"Marra","year":"2016","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_12","first-page":"15","article-title":"Cardiac magnetic resonance imaging in the evaluation and management of mitral valve prolapse: A comprehensive review","volume":"26","author":"Mangini","year":"2024","journal-title":"J. Cardiovasc. Magn. Reson."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/2\/94\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:11Z","timestamp":1760032331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/2\/94"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,14]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["reports8020094"],"URL":"https:\/\/doi.org\/10.3390\/reports8020094","relation":{},"ISSN":["2571-841X"],"issn-type":[{"type":"electronic","value":"2571-841X"}],"subject":[],"published":{"date-parts":[[2025,6,14]]}}}